Unusual magnetic resonance imaging of the head in manganese and ephedrone intoxication - a case report.

Karol Jastrzębski, Piotr Gałecki, Sergio I Sanchez

Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego 2021 Dec 16

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Manganese intoxication leads to the accumulation of manganese in the brain, mostly in the globus pallidus, which clinically manifests as a L-DOPA - resistant parkinsonian syndrome with specific symptoms, such as spastic-hypokinetic dysarthria and postural instability. A new kind of manganese poisoning associated with drug abuse has been reported in Eastern European countries. We present an adult patient with neurological abnormalities secondary to manganese intoxication related to the abuse of psychoactive substances. High serum levels of manganese, hyperintense lesions on T1-weighted magnetic resonance imaging (MRI), and parkinsonism in this case confirmed the diagnosis. MRI results showed accumulation of manganese in the basal ganglia which caused an increased signal in this area of the brain on T1 weighted sequence. This is the second case reported with diffuse high signal intensity of the entire white matter due to manganese and ephedron neurointoxication. To the best of our knowledge, this is the first time such extensive pathological changes to cerebellar white matter, located near the fourth ventricle, have been described. We suggest that chronic exposure to manganese and ephedron damaged the white matter in the cerebral hemispheres and continued to affect the periventricular area of the fourth ventricle, causing continuous changes to the white matter. © 2021 MEDPRESS.

Citation

Karol Jastrzębski, Piotr Gałecki, Sergio I Sanchez. Unusual magnetic resonance imaging of the head in manganese and ephedrone intoxication - a case report. Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2021 Dec 16;49(294):434-436